About Stress, the Chronic Illness of Modern People

1. What Is Stress?

Because of increasingly complex social structures, excessive work and study demands, and difficulties in interpersonal relationships, modern people live while experiencing stress (stress). To manage stress properly, it is first necessary to understand what stress is. The word stress originally came from the Latin word stringer, meaning “to tighten,” in the field of physics in the 19th century. In the medical field, Hans Selye defined it in the 20th century as “a response that resists change in order to maintain a stable state when confronted with stimuli that try to disrupt mental and physical balance and stability.” Selye divided stress into three stages: ① alarm → ② resistance → ③ exhaustion. He also presented the theory that if stressors continue for a long time and one falls into the final stage, exhaustion, they can develop into physical and mental illness.

2. The Two Sides of Stress

Stress can be divided into positive stress and negative stress. Stress that may feel burdensome at the moment but, if handled appropriately, can improve one’s future life is positive stress, while stress that continues despite one’s coping or adjustment can be called negative stress because it may cause symptoms such as anxiety or depression. Appropriate stress can energize our lives and increase productivity and creativity. In other words, stress can include both positive and negative life events, but when people generally think of a stressful situation, they usually refer mainly to stress related to negative life events. American psychologist Lazarus reported that even the same stressor can function as positive stress or negative stress depending on the person experiencing it. When a stressor occurs, a primary appraisal takes place first to determine how threatening it is or whether it is worth taking on as a challenge. If it is assessed as threatening, the next step is a secondary appraisal, in which various coping responses are considered to deal with the negative emotions caused by the threat. Therefore, if a stressful situation is taken negatively, it can eventually lead to illness, but if it is taken positively, it can make a person productive and happy. In the case of positive stress, it acts as a lubricant in life and can build confidence while increasing work productivity and creativity. Ultimately, accepting it as good stress, as explained above, can be the key to health, happiness, and success.

3. Distinguishing the Meaning of Stress

When ordinary people talk about stress, they often use the terms stressor and stress response interchangeably without distinguishing between them. For example, expressions such as “My boss is stressing me out (stressor)” and “I’ve been under constant stress lately (stress response)” are used as if they refer to the same concept. In terms of terminology, stress refers to the stress response, but to clarify the concept, it is also explained by dividing it into stressors (causes) and stress responses (symptoms).

4. Factors of Stress

Any form of change can first be divided into external and internal factors when classifying stressors.

● External factors

· Physical environment: noise, light, heat, warmth, enclosed spaces, reduced convenience, etc.

· Social environment: organizational environment [rules, regulations, formal procedures, deadlines, etc.], social relationships [others’ rudeness, orders, etc.]

· Personal events: important events [birth, aging, illness, and death; economic changes; job loss/business failure; promotion; marriage/divorce/bereavement, etc.], daily events [commuting, machine breakdowns, etc.]

● Internal factors

· Lifestyle habits: caffeine intake, smoking, lack of sleep, excessive schedules, etc.

· Distorted cognition: negative self-view [pessimistic thinking, self-blame, excessive analysis, thought traps, exaggeration, rigid thinking, etc.], personal traits [perfectionism, workaholism, etc.]

Effects of Stress on Health

1. Effects on Mental Health

When people are under stress, anxiety symptoms (restlessness, worry, concern, etc.) appear at first, and depressive symptoms gradually emerge. In most cases, anxiety or depressive symptoms are temporary and disappear once the stress passes. However, if the stressor is too excessive or lasts too long, or if a person’s ability to endure the stressful situation is weakened, it can develop into various mental illnesses. Mental illnesses that commonly arise from stress include adjustment disorder, anxiety disorders, mood disorders, eating disorders, sexual dysfunction, sleep disorders, somatic symptom disorders, and alcohol and substance use disorders. Hwa-byung, common among housewives in Korea, can also be viewed as a mental illness closely related to stress.

2. Effects on Physical Illness

Physical illnesses are also closely related to stress. Considering research showing that about 70% of hospitalized internal medicine patients are related to stress, it is already well known that stress acts as a cause or aggravating factor in physical illness. In such cases, a psychiatric diagnosis of psychosomatic disorder is made. This diagnosis is used when a physical illness occurs or worsens due to mental or psychological factors, and the treatment outcome also varies greatly depending on those mental or psychological factors. In particular, the musculoskeletal system (such as tension headaches), the gastrointestinal system (irritable bowel syndrome), and the cardiovascular system (hypertension), which are vulnerable to stress, are known to be more affected.

3. Effects on Immune Function

Long-term stress weakens immune function, making a person more susceptible to disease. It is known to have a major impact not only on the onset and worsening of various psychosomatic disorders, but also on serious illnesses such as cancer.

● Psychological symptoms

· Anxiety, worry, concern · Nervousness, impatience, inability to wait · Irritability, anger · Dissatisfaction · Forgetfulness, difficulty concentrating

· Indecisiveness · Frustration, exhaustion, depression

● Physical symptoms

· Musculoskeletal: headache, stiff neck, teeth grinding, shoulder pain, lower back pain, arthritis, etc.

· Limbs and skin: cold hands and feet, sweating, itching, skin rash, etc.

· Gastrointestinal: nausea/vomiting, hyperacidity/heartburn, constipation, diarrhea, abdominal pain, enteritis, etc.

· Cardiovascular: rapid heartbeat, irregular pulse, palpitations/dizziness, chest pain, high blood pressure, myocardial infarction, etc.

· Respiratory: breath-holding, hyperventilation, asthma, etc.

· Other: trembling, inability to sit for long periods, daydreaming, sleep disorders (insomnia/excessive sleep, nightmares), fatigue, sexual dysfunction, reduced immunity (frequent colds, worsening cancer, etc.), stroke, etc.

● Behavioral symptoms

· Restlessness, nail biting, foot tapping

· Overeating, heavy drinking, increased smoking

· Violent speech and behavior

· Self-harm/suicide, harming others/killing others

So far, I have explained the overview and effects of stress.

In the next part, we will look at how to manage stress.

Source: Korea Disease Control and Prevention Agency, National Health Information Portal